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张进华,杨 正,韩玉玲,郑 勇,许 莹.功能性电刺激对痉挛型脑瘫儿童下肢功能的影响[J].中国康复医学杂志,2009,24(4):328~330
功能性电刺激对痉挛型脑瘫儿童下肢功能的影响    点此下载全文
张进华  杨 正  韩玉玲  郑 勇  许 莹
天津市儿童医院康复科,天津,300074
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摘要:
      目的:探讨功能性电刺激(FES)对痉挛型脑性瘫痪(脑瘫)患儿下肢功能的影响。方法:39例(年龄24—60个月)有行走能力且存在踝跖屈肌痉挛的双瘫患儿随机分为FES组(21例)及对照组(18例)。FES组采用12周康复训练治疗,前6周辅以FES;对照组仅进行12周康复训练。分别在治疗前、治疗6周和12周进行腓肠肌痉挛评分(改良Ashworth分值,MAS)、踝关节关节活动度(ROM)以及粗大运动功能量表(GMFM)评定。结果:两组患儿治疗6周和12周后,MAS量化评分下降,GMFM站立及走跑跳两大功能区评分提高,与各自治疗前相比,差异均有显著性意义(P<0.05或0.01);FES组患儿治疗6周和12周后,对照组患儿治疗12周后,踝关节ROM较治疗前明显增加,差异有显著性意义(P<0.01)。治疗6周和12周后,FES组MAS、踝关节ROM及GMFM等指标均优于对照组,差异有显著性意义(P<0.01)。结论:结合运动训练,FES可成为痉挛型脑瘫患儿下肢功能康复的一种有效治疗手段。
关键词:功能性电刺激  脑性瘫痪  痉挛  下肢
Effects of functional electrical stimulation on motor function of lower extremity of cerebral palsy children with spastic diplegia    Download Fulltext
Department of Rehabilitation, Tianjin Children′s Hospital, Tianjin, 300074
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Abstract:
      Objective:To study the clinical effects of functional electrical stimulation(FES)for improving lower extremity functional performance in cerebral palsy(CP) children with spastic diplegia. Method:Thirty-nine CP patients (aged 24—60 months) with spastic diplegia were randomly divided into FES group (n=21) and control group (n=18). The patients in FES group received combination treatment of 12-week rehabilitation training and FES during first 6 weeks, while those in control group were only treated with 12-week rehabilitation training. Modified Ashworth Scale(MAS), range of motion(ROM)of ankle and the gross motor function measure(GMFM)were evaluated at the beginning and at the end of the 6th and 12th week of treatment course respectively. Result: MAS decreased and GMFM scores increased in both groups at the end of 6th and 12th week of treatment(P<0.05 or 0.01). In FES group ROM of ankle significantly increased at the end of the 6th and 12th week of treatment, while in control group increased only after 12 weeks of treatment(P<0.01). Compared with control group, MAS and ROM of ankle and GMFM scores in FES group patients significantly improved at the end of 6th and 12th week of treatment(P<0.01). Conclusion: FES is an effective therapeutic method for improving lower extremity motor function in CP children with spastic diplegia.
Keywords:functional electrical stimulation  cerebral palsy  spastic  lower extremity
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